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Severe Constrictive Pericarditis After Parvovirus B19 and Human Herpes Virus 6 Infection in a 9-Year-Old Girl |
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| Authors: | David Backhoff Michael Steinmetz Wolfgang Ruschewski Barbara Stastny Reinhard Kandolf Ulrich Krause |
| Affiliation: | 1. Department of Pediatric Cardiology and Intensive Care Medicine, Georg-August-University Hospital G?ttingen, University of G?ttingen, Robert-Koch-Str 40, 37075, G?ttingen, Germany 2. Department of Thoracic Cardiovascular Surgery, Georg-August-University Hospital G?ttingen, University of G?ttingen, G?ttingen, Germany 3. Department of Pediatrics, Kassel School of Medicine, Kassel, Germany 4. Department of Molecular Pathology, University Hospital of Tübingen, University of Tübingen, Tübingen, Germany |
| Abstract: | We report on a 9-year-old girl who developed signs of congestive heart failure with significant ascites due to constrictive pericarditis. Cardiac catheterization was performed to establish the diagnosis and to rule out restrictive cardiomyopathy. Endomyocardial biopsies were positive for activated macrophages and small-vessel disease, but no viral genomes were detected. Open pericardectomy was performed and histopathologic examination of the resected thickened pericardium showed extensive fibrosis and hyaline degeneration. A combined infection with parvovirus B19 (PVB19) and human herpes virus 6 (HHV6; subtype B) was proven within the resected pericardium. We suggest that local HHV6-induced immunosuppression enhanced the PVB19 infection, thus resulting in chronic infection and leading to constrictive pericarditis. |
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